St. Maarten Judge Delivers “Verdict” On Caribbean Hospital

CAYMAN ISLANDS (May 5, 2017) – Retired St. Maarten Judge Reuben Essed has received a lifesaving pacemaker for his heart in the Cayman Islands.

Judge Essed, one of an increasing number of patients from St. Maarten to receive tertiary care at Health City Cayman Islands, has had a preventative pacemaker implanted by doctors at the Joint Commission International-accredited facility.

The retired judge was advised by his cardiologist, Dr. Meredith Sedney, to consider a pacemaker – but to have the procedure done at Health City because St. Maarten did not have the sophisticated capacity needed for the surgery. “There are some procedures that we are never going to do in St. Maarten. For that, it is good to have a good contact with a hospital who can do all these procedures,” she said.

Among the things that impressed the St. Maarten cardiologist was the transparency of Health City personnel like Chief Interventional Cardiologist and Electrophysiologist Dr. Ravi Kishore: “I’m very impressed about how he is working and how I’m able to discuss cases with him. Especially when they are not clear-cut cases. So, brainstorming with Dr. Ravi is absolutely fabulous. That’s why we bring the patients here and sometimes it’s not needed to bring the patients here because we have just discussed before. And that’s a great thing – the communication.”

It transpired that Judge Essed’s case was a complicated one which, Dr. Kishore agreed, needed close consultation with the patient and his primary cardiologist.
“We finally managed to come to a conclusion that Mr. Essed may not require cardiac resynchronization therapy because his heart function is pretty reasonable. However, his ECG (electrocardiogram) abnormality suggests that he may be at risk of developing intermittent heart block, which can be pretty dangerous. Especially when you are on an island with limited acute tertiary medical care,” Dr. Kishore said.

After discussions with the patient and his cardiologist, Dr. Kishore put him on a pacemaker as a backup in case he suffered from intermittent heart block. Dr. Kishore described the treatment as “prophylactic pacing”.

“You are pacing, anticipating a potential problem. It’s not that he actually developed the problem and you are taking care of it. So, this is something like a primary prevention. Like you reduce your cholesterol in your diet to prevent a heart attack, whether you have a heart attack or not,” he explained.

Dr. Sedney was certainly heartened by the expertise of the Health City staff and explained why she would recommend her compatriots to fly to the Cayman Islands facility:  “The personnel around the procedure is very good. There are anesthetists, there are technical persons measuring the pacemaker, the cardiac surgeon, and Dr. Ravi himself. It was smooth working together as a team … I was impressed.”

Judge Essed, with his new pacemaker implanted, laid down his verdict: “I recommend this institution to everyone, wherever in the world, who might need some medical attention, especially in this field.”

A growing number of St. Maarten residents are receiving critical care at Health City as part of an agreement between the hospital and SZV Social & Health Insurances, the government-owned national health insurer in St. Maarten, through weekly flights operated by Cayman Airways to provide tertiary healthcare to those who are awaiting treatments unavailable on the island.

And as Dr. Kishore points out, it makes good economic sense, too. “We have earlier managed some patients of St. Maarten with great success and with fantastic outcomes at a much lower cost to the insurance company. I guess that has provoked the continued inflow of patients.”